But over time the new concept did seem to come right and despite the many problems which modern treatment methods throw up we do seem to have moved toward a more compassionate form of caring for people with serious mental ill health and the old problems of institutionalisation and abusive care staff seem now far behind us. 3 rd person … 8. 3. Schizophrenia has been around for a long time. Dispose of PPE appropriately and wash your hands. Apart from the abuses that occurred in a small number of these institutions, one of the major criticisms of the system was seen as the “institutionalisation” of the patients. Schizophrenia is surprisingly common, affecting 1 in every 100 people … These statements should be based on what you believe to be the crux of the issue. Treatment with antipsychotic medication remains the mainstay of treatment in the NHS although many do benefit from talking therapies provided by their local NHS or charities like Mind or Rethink. Questions which may be useful to explore thought blocking include: Thought withdrawal refers to a patient’s belief that thoughts can be removed from their mind by others. 7. The 1983 Act also introduced new safeguards against people being wrongfully confined including an independent appeals system. Questions which may be useful to explore passivity include: Ask the patient if they have any questions or concerns that have not been addressed. Coronavirus: Are People with Schizophrenia at Higher Risk? This breakthrough began when, in the early 1950’s, a French naval surgeon called Laboret experimented with a new drug called chlorpromazine to help with post-operative shock in his patients. Others see the very large number of people living with schizophrenia who are confined in our prisons rather than in hospital as being a lingering throwback to the old days before the Victorians built their asylums. The doctor takes the patient's history and performs a physical exam. The whole programme was overseen by an organisation which went under the amazingly euphemistic title of the Charitable Foundation for Curative and Institutional Care. Simple schizophrenia That is that very large numbers of those confined in the asylum became so dependent on the institution providing for them that they could not cope in the outside world and so could not be released even though their condition had long since improved. Tests and screenings. It has to be said that care in the community got off to a very shaky start. Although substance abuse cannot cause schizophrenia, it can act as an environmental trigger. Reports of schizophrenia-like illness can be found even in ancient literature. With the election of John F Kennedy (whose younger sister had experienced mental illness) in 1960 the federal government provided the funding for the move to de-institutionalisation.4 In the UK also the start of the move towards emptying the asylums can be charted to the 1950’s and drew as its inspiration the work of the American reformers.. Aaron Beck the US psychologist who pioneered cognitive behavioural therapy. Swiss psychiatrist Eugen Bleuler who first used the term schizophrenia in 1911. Whereas a full and enduring recovery requires the active participation of the patient it is still the case in this cruel illness that there will be times when the patient’s judgement becomes so distorted that treatment decisions need to be taken by their doctor or when the patient’s thinking becomes so disturbed that they become a danger to themselves or to others and have such poor insight into their condition that they remain oblivious to the risks. History Taking & Risk Assessment 6 2.1 Presenting Complaint & HPC 7 2.2 Past Psychiatric History 7 2.3 Medication 8 2.4 Family History 8 2.5 Personal History 10 2.6 Premorbid Personality 11 2.7 Difficult Questions, Difficult Patients 12 The Third Reich represents one of the most significant challenges for schizophrenia sufferers in the history of the condition not simply because thousands of people with schizophrenia died as a result but also because this tragic episode in modern European history points up the constant threat that people living with schizophrenia face from the followers of eugenics. At about the same time that the new antipsychotics were being developed, psychologists in the USA were trying out a new form of psychotherapy called cognitive behavioural therapy or CBT which appeared to show great promise. Photo: Guy Wareham. Schizophrenia was thought to be an inheritable disorder, and as such sufferers were subject to Eugenics and sterilisation. In fact the oldest recorded description of an illness like schizophrenia dates back to the Ebers Papyrus of 1550BC from Egypt.1, Descriptions of episodes of madness involving hearing voices, seeing visions and erratic and unruly behaviour start to appear in the literature from the 17th century. Schizophrenia was first described by Dr Emil Krapelin in the 19th century. 2. In-patient treatment in the new generation of mental health units usually attached to the local hospital is confined to people in crisis or people whose condition may put them in danger of harming themselves or others. Whilst they were good at controlling symptoms, the first generation of antipsychotics such as chlorpromazine, haloperidol and flupenthixol were not without their problems and tended to cause more problems with side effects than the more modern ones. Treatment is usually provided by a multi disciplinary team consisting of a consultant psychiatrist, a community psychiatric nurse and social worker support. The Diagnostic Status of First-Rank Symptoms. Faced with the seemingly intractable problem of an incurable condition that led to disturbed behaviour, in the 1930s the Nazi regime in Germany embarked on an ambitious programme to eradicate schizophrenia from the race by the use of euthanasia. No definitive diagnostic tool for schizophrenia but certain tests like CT scan and MRI may be ordered to rule out disorders than can cause psychosis (e.g. Today there are about 280,000 people being treated for schizophrenia in the UK. Photo: Bealivefr. Compulsory confinement and compulsory treatment usually known as “sectioning” are still tools available to the psychiatrist today under the 1983 Mental Health Act and for some patients are the best treatment options available. In the middle of the 20th century scientists developing new types of antihistamine drugs found that the new drugs were also effective in controlling the psychotic symptoms of schizophrenia. 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